Author Topic: Diagnosing Chronic Renal Failure (CRF)  (Read 1333 times)

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Diagnosing Chronic Renal Failure (CRF)
« on: August 30, 2009, 12:24:29 PM »
aprnjam



Joined: 29 Apr 2003
Posts: 85

   
PostPosted: 03 Jun 2003 08:57    Post subject: Diagnosing Chronic Renal Failure (CRF)    

In order to diagnose CRF, the physician must first determine it is is acute, chronic or acute superimposed on chronic. When your serum creatinine rises to 1.5 -2.0 mg/dL, you will progress to CRF, and this may occur even if the underlying disease process is inactive. As you approach end-stage renal disease (ERSD), it becomes more and more difficult to make a precise diagnosis. In order to make a definitive diagnosis, your physician may want to do a kidney biopsy. However, this is NOT recommended and ultrasound detects that your kidneys are small and fi
otic.<
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>A kidney biopsy is not normally painful. You are admitted to the hospital overnight for observation following the procedure. You will be instructed to report to the hospital, and to have nothing to eat or drink after midnight. You will be taken to the biopsy room, an intravenous fluid will be started in your hand, and you will be asked to lie on your stomach. The selected kidney area (right or left) on your back will be cleaned. The nephrologist will insert a long, small, needle through the skin, muscle, and into the kidney. The biopsy needle has a small device that will allow the physician to take several tissue samples of your kidney. These samples will be sent to pathology for a definitive diagnosis of the type of kidney disease that you have. You will remain in the hospital overnight to ensure that there are no complications from the procedure and you will be discharged home the next day. The reason you are monitored overnight, is there is a small risk of bleeding, and it much better for you to be at the hospital should this occur.<
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>Your serum BUN and creatinine will be elevated and will be monitored frequently by your nephrologist. Your serum sodium (Na) levels may be normal (135-145 mEq/L) or reduced (less than 135 mEq/L). The serum potassium (K) is normal or slightly elevated (less than 6 mMol/L), unless you are using potassium-sparing diuretics, ACE inhibitors, beta-blockers, or angiotensin receptor blockers. Your serum calcium, phosphorous, parathyroid hormone (PTH), vitamin D metabolism, and renal osteodystrophy can also occur. Hypercalcemia and hyperphosphetemia are regularly found.<
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>Usually, you will have moderate acidosis, with a CO2 level of 15-20 mMol/L, and you will also likely be anemic.<
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>The anemia that you will experience in CRF, is normochromic-normocytic, and your hemocrit will usually run 20-30%. If you have Polycystic Kidney Disease, your hemocrit will usually run 35-50%. The anemia is usually caused by a problem with the production of erythopoietin because there is a reduction of your functional renal mass. Other causes of anemia can be deficiencies in folate, iron and cyanocobalamin (vitamin B12), which can be replaced with a dietary supplement.<
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>Your urinary volume will not respond readily to increases or decreases in your intake of water. Urine osmolality is normally fixed closed to plasma osmolality (300 to 320 mOsm/kg).<
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>When your physician does a urinanalysis, the findings will depend on the underlying disease process. Normally
oad (usually waxy) casts are often found in advanced renal insufficiency, no matter what the underlying cause. <
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